Here's an interesting article about a proposal in England regarding healthcare. The report calls for a greater emphasis on the "citizen's responsibility" and heavy smokers, the obese and binge drinkers who were a drain on the NHS could be denied some routine treatments such as hip replacements until they cleaned up their act.

Health care costs are skyrocketing, and they are choking American businesses. In my company, the only cost we have that exceeds the annual health insurance bill, is employee salaries. Insurance costs have been increasing at 10 to 15% per year for 5 years now.

Something must be done to control health insurance costs. Administrative costs of insurance eat up as much as 30% of the money we Americans spend on Health insurance. If a single payer system or rationing of health care is what will protect the ability of American companies to keep Americans employed in America, I'm all for it. Look at GM. Heath care costs are killing them, and lots of other American companies, too.

If the jobs are driven out of the country because of run away health care costs, it's not gonna matter what kind of health care system we have - no one will be able to afford it.

I'm sorry if I seem so incredulous, but the logic of what brewer of beer says is overwhelming. The emotion surrounding the health care debate in the US is obscuring the issues. The multiplicity of insurance companies and plans is the problem rather than the solution.

A good start to reforming health care is to ban group health insurance. These plans, while they may sound reasonable, have as their purpose the willowing out of the unhealthy and they are highly effective at that purpose.

Ever been in the Army Dan? Ever gone to a Troop Medical Clinic? I have. It ain't pretty or fun. If you think the lines and service at the DMV are bad, just wait until the government gets their hands on your health care.

And by the way, Socialism refers to a broad array of doctrines or political movements that envisage a socio-economic system in which property and the distribution of wealth are subject to control by the community for the purposes of increasing social and economic equality and cooperation. This control may be either direct—exercised through popular collectives such as workers' councils—or indirect—exercised on behalf of the people by the state. As an economic system, socialism is often characterized by state or community ownership of the means of production.

Ending group health insurance has nothing to do with single payer health plans - your definition of "socialism." Health insurance companies can still get their cut in shuffling paperwork. Real people with real problems would get taken care of. You or your's may one day be one of these people, Bob.

Again, very few people are advocating government-operated health care. The overwhelming support is for continuing the current system of predominantly private providers. What there is a growing advocacy for is some kind of public or quasi-public sponsored insurance system with a single payer and administrator that would guarantee a basic level of coverage for everyone.

Almost no one favors the current poor-quality system of medical care operated by the military services or the VA. But there is relatively widespread support of the Medicare system for seniors and calls for finding a way of extending something like it to the general population.

The British health care system, where most of the providers are employed by and the hospitals operated by the National Health, may not be the best model for the US. That should not preclude seeking a better solution more appropriate to American needs and attitudes.

I recently had surgery - and I was astonished by what the hospital billed and what they actually received as an accepted payment. The surgeon billed 6500 for the procedure - accepted 1800, the anestesiologist (sp) billed 2300 received 1950, the hospital billed 22,000 for 2 nights in the hospital and received 6200. Theses bills were considered paid in full from all parties. It makes no sence to me where they come up with these numbers or how they are paid.

There has to be a sufficiently large pool to spread the risk. I can think of when I had hip replacement surgery at total cost of nearly $40,000, 90 percent of it paid by my employer's health insurance carrier at the time. Was it fair to that insurer or employer, where I worked for just over two years, when with a previous employer where I worked for more than six years my total claims were less than $500 during that time?

There is no better solution if someone pays in and never uses it while paying the same amount as someone who uses huge amounts of the resource.

Face it, there is no fair way. Someone is going to get screwed somewhere along the line. However, I can pretty much say it won't be the wealthy, the politicians or the well connected.

Liquid, they charge those rates because they are the starting point for what they know to be a downward negotiation. If they started at what they would accept, they would be negotiated down from there.

The actual billed figures really don't mean anything for most. Most payers have a set amount that they pay for a particular thing, and that is what you get. But, the prices are set for survival; those who pay subsidize those who don't. A drug dealer following a shootout is dumped off at the ER and gets life saving surgery and a stay in intensive care. Who's paying for that?

As an insider, I admit that the system is completely screwed up, and government, insurance companies, lawyers, hospitals, doctors and the citizens who use the system are equally at fault. In my opinion, it can't be fixed well, because too many have there hands in the pot. I guarantee that the vast majority of Americans with insurance now will be unhappy. Restrictions and inconvenience are what did in the HMO's. For those who have no insurance now, nothing will change.

Everyone in the US who needs health care gets it: It's just that those who can't afford insurance, get treated in the ER, at tremendous expense, paid for by those of us who have health insurance.

The current system is horribly broken. Those who can't afford health care, get the most expensive care possible, paid for by everyone else.

I am fortunate to have some of the best health care coverage in the country, if not the world. So why should I care about this issue? Because increasing insurance costs mean that at my company, the employees no longer get annual cost-of-living raises. These pay increases are now absorbed by rising health insurance premiums. At the rate the insurance premiums are increasing, things being to look really ugly when projected out 10 years.

Best doesn't mean perfect, and tragic things do happen, sometimes from innocent mistakes, sometimes from negligence and sometimes even when no errors were made. Humans are involved. If you want perfect, I think you need to get your health care from God. I guarantee you Dan, there are more doctors losing sleep every night over mistakes they might have made than politicians over mistakes they did make.

Human mistakes I can forgive, but setting up systems that intentionally have to deliver bad service to minimize losses, I have a hard time with. I have to believe that all ERs in the country are understaffed to make them unattractive to the uninsured. So what you might say? It causes poor service to everybody, including the insured. December before last this sort of thing came within 15 minutes of costing my perfectly insured and pregnant niece her life.

I can not argue that many bad experiences are had in emergency rooms. In many of them, the first person you see is a cop, instead of a triage nurse. If the hospital doesn't survive, though, there is no emergency room at all (cost cutting never excuses bad care). There are shortages of nurses and medical technologists everywhere. There are shortages of physicians nearly everywhere. On a near annual basis, Medicare simply decides they are going to cut what they will pay by say 7% or 10% or 12%. Insurance companies usually follow suit (and they continue to make enormous profits, despite everyone elses struggle to survive). Hospitals (and doctors) can only go so far to make up that difference by increasing services (meaning more and more exprensive tests thay may not really be necessary, and the government partially justifies cuts by admitting this will happen). You can only do so much to increase the revenue, so you have to cut expenses, as well, which usually means staff. An in some environments, the proportion of population under- or uninsured is great enough that increasing services can not work, because no one is paying for them, and so the only solution is staff cuts.

It's wrong, and it is only part of the problem, but if you think it's bad now, wait until the Feds take it over (it's inevitable). Just take a look at the VA and military systems. They've proven they're not up to the task.

I don't doubt that there shortages in medical help. I don't think that the back up in ERs is due to the general shortages. I believe that the hospitals are desperate to avoid becoming the "go to" place for the uninsured so they intentionally understaff ERs. Maybe rural hospitals that don't have much competition can afford to give proper service, I don't know.

My youngest cousin was wounded by a mine in Iraq a while back. His parents rave about the care he is getting for his eyes. He now is missing only the center field of vision in his one eye.

I think there is general agreement that Medicare for US seniors is at least adequate in providing a basic level of care. Note that I did not say outstanding or ideal. Supplemental insurance is recommended to fill in the gaps and augment the care, but it's not absolutely required. That's likely to be as good as we can expect today.

But guys, that's just the point. Bill, you say Medicare is at least adequate but supplemental insurance is recommended to fill the gaps.

Let's translate that to our state-run proposal here in WI. I think it's a safe assumption that our state run health care would be run no better than the feds. Studies of our "Healthy Wisconsin" plan have shown that it will more than double my monthly health insurance costs as it is. If I have to start paying double what I'm paying now there's no way I can afford supplemental anything.

Dan, I forget what the actual numbers are for the employers. I do remember their taxes are go up significantly under the plan compared to what they pay out towards our current plan, but to be totally honest I don't remember how much more it was. Needless to say I remember the numbers on the increase in personal income taxes more because it affects me directly.

I don't hear anyone blaming the actual insurance companies that are raking in "billions" in profits but still increase rates. These companies are in it for the money, don't be fooled into believing they have your best interest in mind

Group plans are the way insurance companies weed the healthy from the unhealthy. Oddly they only want to insure the healthy while driving the unhealthy away. This is great - so long as you are among the healthy.

There is enough money in the system for the time being, it's just that too much of it is spent on non-medical stuff.

For example, my son recently had some minor surgery to remove a cyst from under his eyebrow. The doctor's office was small (one doctor) but on his staff was a full-time person who did nothing but deal with the multiplicity of varying health insurance companies.

This is where I address those who so fear "socialized medicine." I only want to ban the practice of putting people into "groups" that are designed to weed out the sickies. I am willing to tolerate the profit that insurance companies take on shuffling needless paperwork around making sure that there is no waste by wasting money so long as the unfortunate among us are assured that they will not go bankrupt if they happen to get into an accident. This could be done totally without the dreaded "government" interference beyond banning group plans.

Insurance companies have been gouging us for years. They take in 100 times the cash that they put out. Maybe a solution would be for the Gov't to start regulating the insurance companies themselves. How can anyone justify increased rates when last years profits were in the billions?

I had a friend who worked for a major disability insurance provider. All claims over a certain amount were reviewed. He sometimes referred cases to a physician or other medical specialist, but his own background was a degree in human resources with a couple of accounting courses. Sometimes whether hundreds of thousands of dollars were paid or not was based on his decision.

We should not begrudge insurance companies their accountants. Good bean counters don't come cheap and you have to remember that they are making life or death decisions. Would you trust your health care to a mere bookkeeper?

Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment, says a report.

Stronach's spokesman, Greg MacEachern, told the Toronto Star that the MP for Newmarket-Aurora had a "later-stage" operation in the U.S. after a Toronto doctor referred her.

"Belinda had one of her later-stage operations in California, after referral from her personal physicians in Toronto. Prior to this, Belinda had surgery and treatment in Toronto, and continues to receive follow-up treatment there," said MacEachern.

He said speed was not the reason why she went to California.

Instead, MacEachern said the decision was made because the U.S. hospital was the best place to have it done due to the type of surgery required.

Stronach was diagnosed last spring with ductal carcinoma in situ (DCIS). The cancer is one of the more treatable forms but Stronach still required a mastectomy -- which was done in Toronto -- and breast reconstruction.

Stronach, who announced last April she would be leaving politics before the next election, paid for the surgery in the U.S., reports the Star.

"As we said back in June when we confirmed the surgery, this is a personal and private matter between Belinda, her family and her physicians. I think you'll understand that because of respect for Belinda's privacy, we refrained from offering specific details around her medical treatment," said MacEachern.

While it is rare for MPs to seek treatment outside Canada, MacEachern said Stronach was not lacking confidence in the system.

"In fact, Belinda thinks very highly of the Canadian health-care system, and uses it when needed for herself and her children, as do all Canadians. As well, her family has clearly demonstrated that support," MacEachern told the Star.

MacEachern did not offer any other details regarding what type of surgery Stronach had or what she paid for it.

humph...if she thinks so highly of Canada'a system, she has a funny way of showing it.

"humph...if she thinks so highly of Canada'a system, she has a funny way of showing it."

Sounds to me like a certain hospital, that happened to be in the US, is considered the best place to get the surgery done. People travel all the time for certain procedures, if they can afford it. Carson Palmer had his knee reconstructed in Houston, does that mean the surgeons in Cincinnati are incompetent?

Sometimes people go to other countries for procedures because there is a clinic that just has more experience with a certain proceudure, that place may have been the first to start doing said procedure, so they have more experience.

Yes, but it is funny how liberals like Michael Moore look toward Canada as a shining beacon of what us Bud swillin Americans should aspire to have in a healthcare system, when the liberal politicians from Canada have to come to Amreica to get the care they actually need.

Liberalism looks good on paper, but in practice you get the Soviet Union.

I will try not to let my opinion of Belinda Stronach color my comments about this situation. There are Canadians whose reaction to her name is rather similar to the reaction of some Americans to Hillary Clinton. Let's say that neither has ever been short on ambition and self-regard. That said, I certainly wish her well in her battle against cancer.

Steve has the right interpretation of this particular case. There is a doctor in California who has had a very high success rate treating the specific form of cancer she has. With a population more than nine times that of Canada, it is not surprising there are more specialists in the US for less-common conditions. Conversely, I can think of a couple of specialized medical conditions where the recognized leaders happen to be in Canada.

Belinda Stronach is also heir to a billion dollar fortune, as well as wealthy in her own right, so in her case money is not a problem. She is easily able to afford the best care she can find, which happened to be in California. Very few people would disagree that the US has some of the best medical care in the world for those with the ability to pay.

This is a very different issue than health care for the average person in either the US or Canada.

Bob, do you agree that's it's an inflammatory statement not intended to further the discussion of the issue at hand (health care)? I'd say it's a (literal) "red herring," fundamentally similar to making a connection between ultraconservatism and fascism, which leads to the mention of "Hitler." We all know what happens to those arguments.

I'll say it again. The polarization of liberal versus conservative, Republican versus Democrat, red state versus blue state that has taken over politics, the media and the public discourse hinders the ability to discuss and address the issues and problems we face.

Bob, where it started has lost its importance. My own opinion is that Rush Limbaugh had a lot to do with it, but others are entitled (and perhaps correct) to fix the origin elsewhere. It's a different debate, anyway.

I certainly don't equate conservatism with fascism. I was pointing out the logical corollary to your connection of liberalism with Soviet Communism.

At any rate, I'd rather not fall victim to the syndrome I was highlighting. Can we move beyond the polarizing labels and rehtoric, and focus on discussing and finding solutions to the problems we face?

Obviously we've moved (and I'm partially guilty of it myself) from the issues to the personalities, from health care to Hillary Clinton and Michael Moore and Belinda Stronach. It's a downward spiral, I'm afraid, a battle almost enirely lost already in most of the media as well as here.

My wife's teenage daughters, who think all politics and public affairs are insufferably boring, point out that politicians and pundits claim to want to talk about issues, but it really isn't much different from the gossip about Britney, Brad and Angelina, and, yes, O.J.

Steve...Ann Coulter is not a Senator, and should not be held to the same standards. Hillary is a Senator, and is running for President. Just think of the uproar in the media if Dick Cheney or George Bush called her Hillary names, like "Thunder Thighs", or "Her Royal Thighness, Hitlery Clinton". The Libs would be hopping around and hooting grunting like they just captured Taylor from Planet of the Apes.

I tend to agree with that Denny, but the vitriol and venom that is constantly spewing from the left side of the sewer tends to have an impact on me.

I was a-political before 9-11, and even had some liberal tendencies. I credit the whacked-out leftist loons in congress for alienating and driving me away.

Sure, for a few short months after 9-11 we were all united. But once the leftist Democrats realized that the country was rallying behind their commander in chief, and it wasn't Al Gore, they had to do something. Their solution was to oppose and denigrate the Bush administration at every turn.

I remember being shocked and appalled by what some of the politicians were saying, and I couldn't figure out why these guys were saying such things until I realized they were all Democrats.

Hate Bush, Bush lied people died, Bush stole the election, No Blood for Oil, Who Would Jesus Bomb?, etc... After a while, it got to me and really disgusted me. In the Army, I was taught that disagreement is not disrespect. Democrats taught me the opposite is true.

So, I guess I have just allowed those vile and disgusting aspects of the left side of the aisle get to me. And even though you guys think my comments are inflammatory or over the top. I think they are accurate and well deserved.

Bob,you need to stop being so myopic and thinking that all the blame rests with only the libs. BOTH sides do exactly the same thing...two sides of the same coin. Almost daily, I flip my radio back and forth between Sean Hannity and Ed Schultz, and I'm continually amazed by the similarities in their approaches. They, and we, need to stop the ad hominem attacks, straw man arguments and name calling and focus on the issues and how to solve them. Honest disagreements and discussion to find common answers strengthen us and our country. When I hear the spewing from the likes of Hannity and Schultz, it says to me they're not interested in making America greater, they're interested in getting their own way.

Amen, Denny! I don't think I could have said it any better. Bob, I've become convinced that the extreme partisanship is the single biggest obstacle we need to overcome in order to deal with problems that must be solved. The attack dogs of the media on both sides are a major hindrance to this.

It seems you're more sensitive to and critical of the voices on the left, but believe me, there's an abundance of vitriol on the right, too. It's gone well beyond the point of weighing where the blame most belongs, and time to bring it to a halt.

I just got a bill today from an outpatient surgery I had about a month ago and noticed something. The surgeon billed for $1920.36 and the insurance company allowed $387.64 and the doctor OK'd that ammount. Now I'm not complaining since I still haven't used up my deductable and this is coming out of my pocket, but in what other industry could anyone discount their bill 79.8% and stay in business?

Granted I arrived at the outpatient center at 6am and was home by 10:30am, and the operation only took 1 hour, but something just ain't right there.

One of the benefits of living in Canada is the high level of supplemental insurance provided by many employers. This includes dental care, which is not covered by the government plan apart from certain services for low-income seniors. I have coverage courtesy of my wife's employer. Checkups and cleaning every six months are covered 100 percent, along with 90 percent of the charges for most other work such as fillings and gum treatment (major restorative work such as crowns and bridges is covered at 60 percent except in the case of injury).

My dentist will forgive the 10 percent co-pay (and discount the co-pay for major work by 20 percent) if I pay by check or credit card immediately after the work is done. It's worth asking your provider if there are alternatives.

My wife gave birth to our son almost 1 year ago, she had some compilations after the delivery, the hospital staff was wonderful and received great care.

My 87 year old father just had his gaul bladder out, he had to go to the emergency room due to an attack a few days prior, he was serviced quickly, had a battery of tests, immediately had a Dr app the next day and we saw a surgeon in less than a week and his gaul bladder was out less than a week after that. The surgeon was great, and the hospital staff was great and my father is doing great

My daughter had to go to urgent care because we thought she broke her wrist (Friday pm). Fast service, the Dr was unsure of the X-ray results so he forwarded to a radiologist, her pediatrician called the next day to see how she was doing (Saturday call) and we had an app with a specialist the following Monday days to see what was the matter. All great service.

I have PPO ins, yes it is expensive, but you get what you pay for and right now I see it as an expense that I can pay for. I have the option for HMO but would never consider it you may get the same MD's but the service is not the same (the MD's have told me that). If "universal health care" is like an HMO then leave me out!

Wives, especially for small businessmen, are a great resource form an insurance perspective. I am glad you would have her as a backup. I think you know where I am going with my question though. Again, life can change.

According to a Mennonite neighbor of mine here in Phoenix, "Insurance is nothing more than a form of gambling. You are betting that you will take more out of it than you put in." I do know that he and his wife have used medical care and have with the help of the Mennonite community paid their bills. He believes it is a sin to purchase insurance and is concerned whether the US government will make a provision for religion as they did with Social Security if they do make insurance mandatory which many politicians think is an oh so swell idea.

I have also touted mandating insurance, but the more I think about it the viler that thought becomes to me. I don't like any government body legislating that I have to purchase any service or product from any private company. I'm a nice guy until someone tries to force me to do anything then I'll give a mule a lesson in stubborn.

I suppose resisting mandated insurance is fine so long as you stay out of ERs and are willing to gamble your whole net worth on your health. The idea behind mandating is that you will carry your own weight of risk without becoming a expensive burden on the rest of us.

Note your neighbor has an effective insurance plan of his own through his church. Nothing wrong with that so long as his church can handle it.

Bob, in virtually every industrialized nation in the world (and the majority of developing countries) other than the US, the health of its people is considered a national resource worth ensuring. Yes, at least at a basic level, the health of each person individually is the shared responsibility of everyone. We can (and should) argue about the extent of the care and how it is provided and paid for, but the principle is relatively simple.

Look Bob, to pacify the "taxes are equal to armed robbery" folks, I am willing to leave the insurance companies piss away 25% of our health care money chasing paperwork to make sure that nothing is wasted. I only want to eliminate group insurance whose only purpose is to remove the unhealthy from their rolls leaving the unhealthy to fend for themselves.

Dan I have to agree with you on group health insurance. It is modern day slavery the way some people feel tied to their jobs just because they have good insurance and are terrified of the possibility that any other job they took no matter how much more agreeable to them would not have as good of insurance if any.

It would be great if I could get private insurance at anything close to what the company pays for my health insurance. I looked into it a couple of years ago and even with my ISA membership the same insurance would cost me $140 per month when according to human resources the company is paying $27 per month for my major medical/hsa plan.

The company covers all that cost since it is a lot less expensive than a PPO or HMO since I have a $2250.00 deductable.

Just been reading in the Granuad (relating to Sicko) that Hospitals can throw out patients who are ill onto the street if they can't pay, is that true? I always treat Moores stuff with a healthy amount of scepticism after watching Farenheit 911.

It depends on the hospital and the jurisdiction, Tom. Some (but not most) hospitals have the right to refuse treatment to those who cannot pay. Few actually do so outright, but as Dan suggests, there are ways of funneling poor patients to publicly operated facilities that in some areas have become the dumping grounds for those without the ability to pay.

As for Michael Moore, he's become a hot button for some people, so I will refrain from commenting about him (ad hominem arguments do little to further the discussion of issues, anyway).

Surprisingly no American network has signed up to show it, I also think the maker has given permission for it to be in the public domain so you may be able to download it from torrent, but don't quote me on that.

Thanks, Tom, for that link and the recommendation. It may take some effort for me to find this documentary, but from what I can tell it confirms my feelings that the "war on terror" is in a sense a self-fulfilling prophecy that fuels both the terrorists and the response. That is, both sides have a vested interest in continuing it. A few people point to a parallel with the Israeli-Palestinian conflict in this regard.

(Sorry for continuing the thread hijack. Perhaps we should move the new discussion to its own topic.)

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